Regularly experiencing panic attacks can severely impact a person’s life, and even become debilitating. Unfortunately, recovery isn’t always straightforward, and for those who prove treatment-resistant to frontline intervention, the situation can begin to feel hopeless.
Seeking help from a qualified yoga professional can open up a new therapeutic pathway to panic attack sufferers, and offers a set of powerful tools they can use in their journey to recovery.
What is a panic attack?
For any who has not experienced a panic attack, the extent of the experience can be difficult to understand. Defined by sudden and overwhelming anxiety, panic attacks have such acute symptoms that people will often seek emergency services in the sincere belief that their life is in danger.
The understanding that it is anxiety which is causing the symptoms of a panic attack, such as violent chest pain, shaking, irregular heartbeats, sweating and dizziness is unfortunately no balm for their intensity when they arise.
These symptoms aren’t dangerous, but it is important to differentiate between symptoms that are ‘all in the mind’, and those which are actually caused by activity in the brain and nervous system. The feelings which accompany panic attacks are no less real and distressing than those caused by an identifiable physical problem, even if they are not going to harm the sufferer.
Around this core of symptoms arises fearful thoughts, disturbing emotions, avoidant behaviours and deteriorating relationships. People can start to obsessively seek out the ‘real’ cause of their panic attacks. For example, they may start reading extensive medical literature to discover a problem with their heart a doctor might have missed, or become convinced certain foods are creating an allergic reaction.
People who live with mental health issues such as generalised anxiety disorder (GAD) and posttraumatic stress disorder (PTSD) can experience panic attacks, but they are particularly associated with panic disorder – an illness characterised by regular panic attacks, and the sufferer’s attempts to avoid them.
Those who experience panic attacks may go on to develop other mental health issues. Agoraphobia, which develops as sufferers try to avoid any situations which could prompt a panic attack, is a common comorbidity. As is thanatophobia (a profound fear of death), as panic attacks bring people psychologically to the edge of mortality and can lead them to dwell on their own death.
Panic attacks are also highly associated with depression, both because the two illnesses share vulnerabilities, and due to the fact that recurrent panic attacks can lead to relationship breakdown, job loss and isolation. People can become convinced that they are losing their minds, and as their nervous system becomes increasingly locked into a constant ‘fear’ mode, attacks can be triggered by a growing set of external and internal stimuli.
The causes of panic attacks
There are three major factors inherent to the experience of regular panic attacks, and these are:
- Physiological. Physicians have observed for hundreds of years that panic attacks appear to be caused by problems within the nervous system. This observation led to the development and use of tranquilising drugs such as barbiturates and benzodiazepines. Benzodiazepines are still used in the treatment of anxiety and panic attacks, but are highly controlled due to the potential for tolerance and addiction. Most frequently, panic disorder is primarily treated using antidepressants such as SSRIs. These are effective in relieving symptoms for a large proportion of sufferers, which suggests a biochemical cause.
- Emotional. It is evident that no anxiety or panic is purely physiological. The emotional impact can perpetuate the physical effects of anxiety and worried thoughts and feelings can trigger an attack. As people naturally try to rationalise what they are going through, they may appear delusional or obsessive to others, becoming easily angry, more easily upset, and devoted to intricate patterns of behaviour and avoidance.
- Respiratory. Clinicians and therapists are becoming increasingly interested in the role that disturbed breathing plays in panic attacks. Breathing has a noticeable impact on our autonomic nervous system, and is the only element of this system over which we have conscious control.
All of these factors connect to each other, creating a feedback loop which appears to become more entrenched and difficult to manage the longer that people suffer with panic attacks. The breath-body-mind principle of yoga gives us a system through which to address each layer inherent to the experience of disordered anxiety, treating the patient holistically in a supportive setting.
How yoga can help panic attacks
Early intervention is extremely helpful in the treatment of panic attacks, but due to a variety of factors this isn’t always possible. It also appears that around 40% of patients will be either partially or fully treatment resistant to the primary interventions for anxiety.
It is likely that anyone living with panic attacks (especially if they have done so for some time) will have to embark on a long path to recovery. Yoga can be helpful in this regard because after initial guidance, the practice can be self-directed, and it is a completely sustainable and generally healthy practice. In some cases, it can even provide a framework for living that offers spiritual comfort and support.
There may be cases where yoga can be appropriately applied as a primary treatment in response to anxiety disorders, but in most cases, it’s the integration of yoga with psychotherapy and pharmaceutical intervention that could significantly support recovery. Breathing techniques in particular offer a method through which people can reduce their anxiety in the short term, allowing them to properly engage with other therapeutic practices. Along with basic movements and yogic relaxation techniques, these can easily become a part of a wide array of treatment pathways.
The three primary mechanisms through which yoga therapists (who will have the relevant clinical knowledge to safely and effectively work with those living with panic attacks) can help their clients are:
- Asanas. One of the key elements of panic attacks is uncomfortable physical symptoms. Those who often battle with acute anxiety hold tension throughout their body, and are often hyper vigilant of anything that may be ‘wrong’, and therefore very sensitive to pain and physical sensations. Through asanas, people can stretch their muscles and relieve stiffness, releasing tension and providing a sense of physical wellbeing. As they learn to breath coherently while holding physical poses, their body in turn learns how to regulate itself under physical strain, training the nervous system to become less reactive to stress. Asanas also provide a gentle form of physical exercise, and one that can make other forms of exercise more accessible. Exercise is associated with improved well-being and reduced stress, but people who live with anxiety can be acutely aware of anything that increases their heart rate and therefore find exercise difficult. With the help of a yoga therapist, they can slowly get used to moving again and build their tolerance to physical stress, soon finding that other forms of exercise like swimming and walking becomes an achievable goal.
- Pranayama. Panic sufferers often experience a tightness in their chest or stomach which can make it more difficult to breathe normally, and may hold their breath in order to ‘catch’ it or breathe shallowly. The link between breathing and anxiety is becoming ever more established, and yoga therapists can assist their patients through a programme of breath work which helps them to establish a smooth, unbroken flow of breath. This is extremely helpful to panic sufferers, as disordered breathing contributes to the cycle of anxiety which keeps their nervous system in high alert and leads to repeated moments of psychological crisis.
- Meditation. It is unsurprising that people who experience several panic attacks become increasingly locked into negative thinking patterns. It can be extremely disheartening for people to have to pour all their mental resolve into activities which were once easy and enjoyable, and many can wonder if they will ever feel normal again. Mindfulness is an integral aspect of yoga and one which extensive study suggests can help people both cope with and reduce mental distress. Taken together, the practice of yoga can elicit the body’s relaxation response, and is linked to elevated levels of GABA – a neurochemical associated with feelings of contentment and calm.
yoga therapy supports other treatments (such as medication and talking therapies) and gives people more capacity to engage with their recovery. By bringing people back from the brink of panic and offering a holistic approach to the issue, yoga therapists can play a valuable role in helping people overcome their panic attacks.
Heather Mason is a yoga therapist and founder of The Minded Institute, which offers yoga therapy training to yoga and health professionals.
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